Clinical and immunological outcomes in HIV-2 and HIV-1 and 2 co-infections at a tertiary care centre in Maharashtra
DOI:
https://doi.org/10.18203/2320-6012.ijrms20253611Keywords:
HIV-2, Co-infection, ART, NNRTIsAbstract
Background: HIV-2 and HIV-1 and 2 co-infections are rare but clinically significant subtypes with varying response to treatment and progression of disease exist. Not much data from central India especially Maharashtra is available regarding their immunologic courses. The objective was to examine the sociodemographic characteristics, baseline and follow-up CD4 trends, and antiretroviral therapy (ART) outcomes in HIV-2 and HIV-1 and 2 dually infected patients.
Methods: Retrospective analysis was conducted among 27 patients co-infected with HIV-2 or HIV-1 and 2 who were attending a tertiary ART centre in Maharashtra. Baseline and most recent CD4 counts and ART regimen were analysed. Demographic data, and treatment outcomes like alive on ART, died, transfer out, stopped, and opted out were described using descriptive statistics.
Results: Tenofovir-lamivudine-dolutegravir (TLD) was prescribed in the majority of patients. Mean CD4 baseline count of survivors on ART was 352.3 cells/µl, and recent CD4 improved to 519.3. High mortality was observed in those on protease inhibitor-based regimens (ZL+LPV/r, TL+LPV/r).
Conclusion: TLD-based ART produced better immunological outcome. Protease inhibitor-containing regimens needed in HIV-2, could be associated with poor prognosis in patient on ART.
Metrics
References
Pebody R. HIV-1 and HIV-2. AIDS Map. 2021. Available at: https://www.aidsmap.com/about-hiv/hiv-1-and-hiv-2. Accessed on 18 August 2025.
Agrawal S, Sawant S, Shastri J. Prevalence of HIV-2 infection in Mumbai. Indian J Dermatol Venereol Leprol. 2010;76:709-10. DOI: https://doi.org/10.4103/0378-6323.72453
Johns Hopkins University HIV Clinical Guidelines Program 2000-2025. 2025. Available at: https:// www.hivguidelines.org/guideline/hiv-2. Accessed on 18 August 2025.
Medical news today. 2022. Available at: https://www.medicalnewstoday.com/articles/ 323893. Accessed on 18 August 2025.
Smith RA, Anderson DJ, Pyrak CL, Preston BD, Gottlieb GS. Antiretroviral drug resistance in HIV-2: three amino acid changes are sufficient for classwide nucleoside analogue resistance. J Infect Dis. 2009;199(9):1323-6. DOI: https://doi.org/10.1086/597802
Jallow S, Kaye S, Alabi A, Aveika A, Sarge-Njie R, Sabally S, et al. Virological and immunological response to Combivir and emergence of drug resistance mutations in a cohort of HIV-2 patients in The Gambia. AIDS. 2006;20(10):1455-8. DOI: https://doi.org/10.1097/01.aids.0000233582.64467.8e
Adjé-Touré CA, Cheingsong R, Garcìa-Lerma JG, Eholié S, Borget MY, Bouchez JM, et al. Antiretroviral therapy in HIV-2-infected patients: changes in plasma viral load, CD4+ cell counts, and drug resistance profiles of patients treated in Abidjan, Côte d'Ivoire. AIDS. 2003;17:S49-54. DOI: https://doi.org/10.1097/00002030-200317003-00007
Borget MY, Diallo K, Adje-Toure C, Chorba T, Nkengasong JN. Virologic and immunologic responses to antiretroviral therapy among HIV-1 and HIV-2 dually infected patients: case reports from Abidjan, Cote d’Ivoire. J Clin Virol. 2009;45(1):72-5. DOI: https://doi.org/10.1016/j.jcv.2009.03.011
Peterson K, Jallow S, Rowland-Jones SL, de Silva TI. Antiretroviral Therapy for HIV-2 Infection: Recommendations for Management in Low-Resource Settings. AIDS Res Treat. 2011;2011:463704.
Matheron S, Damond F, Benard A, Taieb A, Campa P, Peytavin G, et al. CD4 cell recovery in treated HIV-2-infected adults is lower than expected: results from the French ANRS CO5 HIV-2 cohort. AIDS. 2006;20(3):459-62. DOI: https://doi.org/10.1097/01.aids.0000199829.57112.2f
Ruelle J, Roman F, Vandenbroucke AT, Lambert C, Fransen K, Echahidi F, et al. Transmitted drug resistance, selection of resistance mutations and moderate antiretroviral efficacy in HIV-2: analysis of the HIV-2 Belgium and Luxembourg database. BMC Infect Dis. 2008;8:21. DOI: https://doi.org/10.1186/1471-2334-8-21
Peterson K, Jallow S, Rowland-Jones SL, de Silva TI. Antiretroviral Therapy for HIV-2 Infection: Recommendations for Management in Low-Resource Settings. AIDS Res Treat. 2011;2011:463704. DOI: https://doi.org/10.1155/2011/463704
van Heuvel Y, Schatz S, Rosengarten JF, Stitz J. Infectious RNA: Human Immunodeficiency Virus (HIV) Biology, Therapeutic Intervention, and the Quest for a Vaccine. Toxins (Basel). 2022;14(2):138. DOI: https://doi.org/10.3390/toxins14020138
Ekouevi DK, Tchounga BK, Coffie PA, Tegbe J, Anderson AM, Gottlieb GS, et al. Antiretroviral therapy response among HIV-2 infected patients: a systematic review. BMC Infect Dis. 2014;14:461.
Kapoor AK, Padival S. HIV-2 Infection. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025. Available at: https://www.ncbi. nlm.nih.gov/books/NBK572083/?utm_source=chatgpt.com. Accessed on 18 August 2025.
Campbell-Yesufu OT, Gandhi RT. Update on human immunodeficiency virus (HIV)-2 infection. Clin Infect Dis. 2011;52(6):780-7.
Pujari S, Patel A, Gaikwad S, Patel K, Dabhade D, Chitalikar A, et al. Effectiveness of dolutegravir-based antiretroviral treatment for HIV-2 infection: retrospective observational study from Western India. J Antimicrob Chemother. 2020;75(7):1950-4. DOI: https://doi.org/10.1093/jac/dkaa112
Zhao Y, Voget J, Singini I, Omar Z, Mudaly V, Boulle A, et al. Virologic outcomes with tenofovir-lamivudine-dolutegravir in adults failing PI-based second-line ART. South Afr J HIV Med. 2024;25(1):1567. DOI: https://doi.org/10.4102/sajhivmed.v25i1.1567
Ekouevi DK, Tchounga BK, Coffie PA, Tegbe J, Anderson AM, Gottlieb GS, et al. Antiretroviral therapy response among HIV-2 infected patients: a systematic review. BMC Infect Dis. 2014;14:461. DOI: https://doi.org/10.1186/1471-2334-14-461
Campbell-Yesufu OT, Gandhi RT. Update on human immunodeficiency virus (HIV)-2 infection. Clin Infect Dis. 2011;52(6):780-7. DOI: https://doi.org/10.1093/cid/ciq248
Eholie SP, Ekouevi DK, Chazallon C, Charpentier C, Messou E, Diallo Z, et al. Efficacy and safety of three antiretroviral therapy regimens for treatment-naive African adults living with HIV-2 (FIT-2): a pilot, phase 2, non-comparative, open-label, randomised controlled trial. Lancet HIV. 2024;11(6):380-8. DOI: https://doi.org/10.2139/ssrn.4605784